Pediatric Forearm Fractures: Investigating the Functional Outcomes of Titanium Elastic Nailing for Unstable Both-Bone Fractures

Abstract

Introduction: Diaphyseal forearm fractures pose a common challenge in children and adolescents, impacting forearm function due to rotational deformities and angulation. The landscape of pediatric forearm fracture treatment has seen limited progression, with increased surgical intervention adoption driven by factors such as functional implications, technological advancements, societal expectations, and legal concerns.

Materials and methods: This study enrolled consecutive children aged 5-16 years with forearm fractures presenting between August 2018 and January 2020, requiring surgical intervention. The study assessed functional outcomes and complications in children treated with titanium elastic nailing.

Results: Sixteen patients underwent surgery for both-bone forearm fractures. Elastic nailing was the primary intervention, with 75% undergoing closed nailing. Patients' ages ranged from 5 to 15 years, with 87.5% being male. The study evaluated fracture characteristics, surgical procedures, post-operative care, and complications.

Conclusion: The study demonstrates promising outcomes for flexible intramedullary nailing in pediatric forearm fractures. Despite the observed complications, the majority of cases achieved excellent results in fracture union and patient recovery, supporting the efficacy of this technique. Larger cohorts are needed for a comprehensive understanding of its applicability and outcomes in pediatric forearm fracture management.

Keywords: Pediatric forearm fractures; flexible intramedullary nailing; functional outcomes; surgical intervention; titanium elastic nailing.

Figure 1

Anteroposterior and lateral radiographs of the right forearm of a 14-year-old boy (a) at presentation. (b) After closed reduction (reduction was attempted considering his age), (c) following titanium elastic nailing, and (d) at 7-month follow-up showing good alignment and fracture union with maintenance of radial bow.

Figure 2

Anteroposterior and lateral radiographs of the left forearm in a 15-year-old boy (a) at presentation, (b) following titanium elastic nailing, (c) at 4-month post-operatively, and (d) at 10-month post-operatively demonstrating delayed union.

Figure 3

Deep infection at ulnar nail entry site, also showing the prominent elastic nail. The wound healed after early implant removal at 2 months.